Spinal deformity and axial traction

Abstract

Axial traction to correct spinal deformity is a very old concept. The oldest reference available is in ancient Hindu mythological epics (written between 3500 BC and 1800 BC) where it is mentioned how Lord Krishna corrected the hunchback of one of his devotees. Later, Hippocrates (460 BC to 377 BC) described certain devices. Galen (131 AD to 201 AD), a follower of Hippocrates, used axial traction with direct pressure. Ibn Sena (980 AD to 1037 AD) in the Middle East also used similar methods. Osteopaths of Turkey also used axial traction to correct spinal deformities. But gradually mechanical methods for the correction of the spinal deformity went into disrepute due to the invariable production of paraplegia. In the past few decades, interest in the correction of spinal deformity has been rejuvenated due to better understanding of anatomy, physiology, and pathomechanics of spinal deformity. Controlled axial traction has been the keystone of several modern procedures such as Cotrel traction, Halo traction, and Harrington Outrigger instrumentation, etc. It appears that the primitive ways of application of axial traction by crude methods did not totally vanish but have been modified. In Indian tribal areas, bone setters still practice it in modified form.